HALF-LIFE: Aripiprazole 74 hours; Active metabolite 94 hours STARTING DOSE: 2mg-15mg daily TARGET DOSING RANGE: 2mg-30mg PO daily BEST TIME TO DOSE: Any HOW TO DOSE: >> Schizophrenia and mania: Initial 10mg-15mg PO daily Max dose 30mg PO daily >> Adjunct for depression: Initial 2mg-5mg PO daily. Increase dose by 5mg per day at intervals of >1 week Max dose 15mg PO daily >> Autism and Tourette's disorder: Initial 2mg PO daily. Increase dose by 5mg/day at intervals of >1 week Max dose 10mg-15mg PO daily PREGNANCY: Minimal data on safety BREASTFEEDING: Minimal data on safety FDA INDICATIONS: 1) Schizophrenia, 13yo and older 2) Acute mania/mixed episodes, 10yo and older 3) Bipolar maintenance 4) Adjunct for Unipolar depression 5) Autism-related irritability, 6-17yo 6) Tourette's disorder, 6-18yo 7) Acute agitation associated with schizophrenia or bipolar disorder (IM)
Partial agonist at D2 receptor
5HT2A affinity less than D2 affinity
5HT1A partial agonist actions more potent than 5HT2A antagonist actions
Usually not sedating (lacks M1 and H1 antagonism)
Minimal weight gain, rare dyslipidemia, rare insulin resistance (except in some children and adolescents)
Minimal to no QTc prolongation
Antidepressant actions partially explained by 5HT1A partial agonism and 5HT7 antagonism
Lower doses may be more activating than higher doses
Monitor for compulsive behaviors (such as gambling) with Abilify
Metabolized by CYP2D6 and CYP3A4
Long acting depot formulations available
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